Bell Green and Wood End, Henley Green, Manor Farm (WEHM) place based profile

What else is happening? What else can be done?

Ensuring communities understand and trust public health messages, and that they are accessible and culturally appropriate is vital. Coventry has a very diverse and active voluntary and community sector with many small and well-connected groups, it is also blessed with many community leaders and “go to” people in local neighbourhoods. During the pandemic the Community Resilience Team created Community Messengers who consisted of existing faith, voluntary and community networks in the city. The number of messengers has now grown to 320. The messengers perform two main functions: -

• they help to disseminate into their community the “stay safe” messages.
• they collect and feedback community intelligence which is then used to influence a number of things such as improving our communication materials, focusing our interventions and deploying our local
  teams of COVID-19 advisors.

Young people were included through a partnership with The Positive Youth Foundation, a charity that supports young people in the Coventry area (and who chair the Coventry Youth Partnership), and a series of focus groups held with young people and the council’s communications team helped the development of
specific messaging for young people, including several videos.

Community members now have a platform and a chance to participate directly in shaping how the council and communities engage with each other. This helps to facilitate a community-led response to communications and messaging surrounding several topics.

There is increasing recognition of the key role that places and communities play in our health. Community groups are best placed to address health challenges, because they are trusted and have the networks understanding and legitimacy to do so. Health and care providers need to shift to an ‘enabling’ leadership style, supporting communities to maintain their health and wellbeing by pooling engagement resources and helping to build capacity by sharing skills and facilities with the communities we serve. The One Coventry Plan is designed to work with our communities to ensure that they can address their health needs and to reduce inequalities.

A community-informed and culturally competent approach to healthcare is essential to increasing screening and vaccination rates. Asylum seekers and refugees typically have worse health than the wider migrant and UK-born population. During migration they are vulnerable to environmental threats – e.g., trafficking, and sexual exploitation – and may have experienced gender-based violence – e.g., torture, sexual violence, FGM, and conflict - that lead to health problems. They, and other newly arrived communities, can also spend long periods of their journey with limited access to healthcare which presents challenges in the form of poorly-managed long-term conditions – e.g., diabetes, and hypertension – and untreated communicable diseases such as TB, HIV and STIs. Newly arrived communities are at increased risk of poor mental health too potentially suffering with anxiety, PTSD, and depression. Therefore, newly arrived communities need healthcare on arrival and information and guidance about the NHS, what services are available, and about their health care rights. The impact of language and cultural barriers cannot be understated so services should be culturally appropriate, and trauma informed.

Building on existing health and wellbeing infrastructures having a collaborative partnership approach, bringing together residents’ experience and partners’ skills and assets, should be taken to strengthen health and wellbeing in communities. The Coventry & Warwickshire Sexual Health Hub is a new service that will operate from a main base in the West Orchards Shopping Centre, three high street sites in Warwickshire and a number of outreach locations across the area including Harmony and Moat House Family Hubs. The service is delivered by HCRG, which currently operates the Walk-In Centre and Anchor and Meridian GP practices. The Hub replaces separate sexual health services operated by CWPT in Coventry and George Eliot Hospital NHS Trust in Warwickshire following a joint procurement between the Council, County Council and NHS England and will deliver a range of testing and treatment services for sexually transmitted infections and contraception services, including a condom distribution scheme. It will also deliver treatment for HIV. HCRG will work alongside the Terence Higgins Trust to improve outreach and help engage with communities.

Demand and access

Why is this important?

The demand for health and care services is expected to increase as the city’s population grows and ages. To manage this growth there is a need to shift the emphasis to proactive and preventative care. This means ensuring people have better general health regardless of where they live, requiring fewer visits to hospital and shorter stays if they need inpatient care; and remodelling urgent and emergency and planned care so that it can cater to the expected increase in demand.

What is the local picture? How does it compare?

The access to GPs is relatively good for residents of the Bell Green and Wood End, Henley Green & Manor Farm (WEHM), around average for Coventry overall.  Wood End Health Centre, Henley Green Health Centre and Bell Green Medical Centre are the main GP facilities that serves the area. Many residents can reach a GP within a 3-minute walk (the dark green areas in the map below), and a significant proportion within a 12-minute walk. However, residents in the northernmost part of the WEHM area, parts of Wood End and around Alderman’s Green, experience less favourable access, as they live more than 15 minutes away on foot from their nearest GP.

Map: Locations of GP practices around the area of Bell Green and WEHM, with walking distances highlighted

Data source: Shape Place, Department of Health & Social Care

While proximity to GP practices is reasonably good in this area, the ratio of GPs per capita of the population is a little lower than the average for the city overall. Another way of understanding access to primary health care in the area is to summarise the total GP resource available at the three practices located in the area. The number of staff including doctors, nurses and other direct patient care staff totals amounts to an estimated rate of 10.2 direct patient care staff per 10,000 patients, a little lower than the Coventry average of 11.0; and 7.7 full time equivalent (FTE) direct patient care staff per 10,000 patients compared to 8.3 across Coventry overall.

Map: Locations of pharmacies around the area of Bell Green and WEHM, with walking distances highlighted

Data source: Shape Place, Department of Health & Social Care

Proximity to pharmacies is relatively good.  There are four main pharmacies that serve the area, namely Henley Green Pharmacy, Henley Road Pharmacy, Lloyds Pharmacy, and Wood End Pharmacy. They are shown on the map above. Serving as crucial hubs for medication distribution and consultation services within the community, most residents of Bell Green and WEHM can conveniently reach a pharmacy within a 15-minute walk, although there are some parts in WEHM (northernmost part of Wood End) that are slightly further away. The dark green areas are within a 5-minute walk to a pharmacy, the light green area represents 15-minute walk.

The Care Quality Commission (CQC) inspect GP practices, all of those in the area that have an inspection result have an assessment of ‘Good’.  We can understand satisfaction with GPs in Coventry by examining responses to the national GP patient survey by Coventry patients annually between 2019 and 2023. It shows that satisfaction levels are lower than average in GP practices local to Bell Green and WEHM. Like for the trend for all Coventry GPs overall, satisfaction levels reduced between 2021 and 2023. The following describes the results across four practices in and near the area, for Wood End Health Centre, Henley Green Health Centre, Bell Green Medical Centre and Longford Primary Care Centre.

In the 2023 survey, when asked ‘Overall, how would you describe your experience of your GP practice?’ Only 58% of respondents from the above GPs said their experience of their GP practice is good or very good, down from 71% in 2021 and notably lower than the city’s 2023 rate of 71%.

When asked ‘Generally, how easy is it to get through to someone at your GP practice on the phone?  Only 43% of respondents felt it was easy, notably lower than the city overall at 59% and a reduction from 53% in 2021.

On a third question, only 45% of respondents registered at practices local to Bell Green and WEHM (listed above) rated themselves as satisfied with the general practice appointment times available to them, again notably worse than satisfaction with this question across all Coventry GPs at 58%.  Like with the other two questions, results deteriorated from the 2021 survey when 53% from Bell Green and WEHM GPs said they satisfied.

What else is happening? What else can be done?

A social gradient approach focusing on people’s prospects and opportunities, housing and environment and lifestyle factors can help improve outcomes, reduce inequality and reducing premature mortality.

The citywide JSNA identified that a culturally competent approach that recognises and makes best use of the assets of the city’s diverse communities is essential. This includes working with local community and religious groups to encourage take-up of vaccination, diagnosis and screening programmes

Health visitors can help support residents to meet their health and care needs – and reduce avoidable demand on A&E. Health visitors are very active in the area, and having support within the community made them feel more at ease. Having different support groups has encouraged socialisation and is seen as a good way for people to meet other people in similar situations to themselves. Further work can be done with the health visiting service, perhaps, including out of hours service, will help people manage their own health problems – without needing to attend hospital.

As part of the Adult Social Care Service, the council are working more closely with other organisations to improve the outcomes for adults. The Improving Lives programme is a partnership programme, led by Coventry and Warwickshire Integrated Care System, bringing together University Hospital Coventry and Warwickshire, Coventry and Warwickshire Partnership Trust and the Council to work as one service. It aims to enhance patient experiences, prevent hospital admissions, and improve hospital discharge processes. The program focuses on effective care through three sub-programs: Interfaces, Hospital Processes at UHCW, and One Coventry Integrated Team. Its key goals are to promote independent living and simplify care delivery through partner collaboration.

Working together in partnership is vital to delivering services to residents. The Working Together Group; an alliance of CWPT, VSCE, and Primary Care in Coventry and Warwickshire, aims to strengthen partnership working within the voluntary, community, faith and not for profit social enterprise sector.

Lifestyles

Why is this important?

Individual behaviours, such as eating enough fruits and vegetables, smoking, alcohol consumption, and physical activity can affect health. These lifestyle behaviours are strongly influenced by the environment in which people live. For example, people living in a ‘food desert’, with limited access to affordable and healthy food, are more likely to eat unhealthily; an unsafe environment is likely to discourage people from walking or cycling; and social and cultural influences, including friendship groups, advertising and media, play an important role in determining people’s lifestyles.

These lifestyle risk factors – poor diet, physical inactivity, excessive alcohol consumption and smoking – are all linked to ill health and premature death. Having a combination of the risk factors contributes to greater ill health. People facing poorer social circumstances are more at risk of having multiple risk factors, exacerbating avoidable differences in health.

What is the local picture? How does it compare?

What else is happening?

The prevalence of smoking is higher than average amongst residents of Bell Green and WEHM. In the 2022 Household Survey 15% of adult residents said that they currently smoked, compared to a city average of 11%. However, as it has been across the city overall, smoking rates in this area have fallen, in the 2018 Household Survey the percentage of residents reporting that they currently smoke was 24%.

Furthermore, the prevalence of e-cigarette usage in both Bell Green and WEHM (Wood End, Henley Green & Manor Farm) is reported at 4% of adult residents, compared to the citywide average of 7%.

Alcohol is causing disproportionate harm to health in Bell Green and WEHM. Alcohol consumption appears to be lower than the city average, but the rate of hospital admissions for alcohol related conditions is amongst the worst in Coventry. In terms of alcohol consumption, responses to the Household Survey 2022 indicate that fewer people than average drink alcohol.  Only 13% of respondents from Bell Green and WEHM said they drink alcohol on at least 2 days per week typically compared to the Coventry average of 25%. Amongst those who drink, 25% in Bell Green and WEHM report consuming more than 2-3 units of alcohol on two or more days in a typical week, while the corresponding figure for Coventry is 24%.

The number of hospital admissions where alcohol consumption is considered a contributing factor when measured using a Standardised Admission Rate (SAR) is amongst the highest of all areas in Coventry in both Bell Green and the WEHM area. Using the broad definition of conditions the rate in Bell Green was 200.5, indicating admission rates at double the national average rate after adjusting for the age structure of the population, 100 representing the England average, and 180.0 for the WEHM area. For the narrow definition of alcohol attributable conditions, a more specific subset of health conditions and diseases that are directly and primarily caused by alcohol consumption, Bell Green and WEHM had rates of 198.8 and 175.0 respectively.

Table: Rates of admissions to hospital due to alcohol related conditions (defined in two ways, broadly and narrowly due to alcohol) by place of residence, 2016/17 to 2020/21

Source: Hospital Episode Statistics (HES) NHS Digital

The importance of eating healthy food remains well recognised by most residents, but there are indications that some aspects of diet are poorer in this area overall, although it is a mixed picture. 91% of respondents to the Household Survey 2022 from Bell Green and WEHM agreed that it was important to eat healthily, similar to the response from across Coventry overall at 93%. 11% of residents said they eat the recommended five portions of fruits and vegetables daily, compared to the citywide average of 21%. 73% agreed that they eat breakfast every day compared to the Coventry average of 78% and 75% agreed that they had everything they need in the kitchen to cook compared to the Coventry average of 81%.

The data also suggests that residents in this area may be more conscious of pricing when making food purchases. 74% of respondents from Bell Green and WEHM agreed that price is the most important factor when buying food, compared to 66% across Coventry overall.

Overall, levels of physical activity amongst adults in Bell Green and WEHM residents are around average for Coventry, as indicated by responses to the Coventry Household Survey 2022. 11% of Bell Green respondents said that they do not take part in any everyday physical activity at all (things such as active travel or gardening) the same as the Coventry average. When it comes to engaging in active recreation, (things such as recreational walking or cycling), 25% of those from Bell Green and WEHM said they do not take part in any, again like the Coventry average of 24%. Engagement in more intense physical activity may be less prevalent here, 51% of respondents said they did not take part in any sports, a lower participation rate than Coventry overall (41%)

While the survey indicates that the number of residents who are completely inactive in Bell Green is not particularly low, 10% saying they took part in no everyday activity; a relatively high proportion of Bell Green residents said they took part in no active recreation, 37%, and in no sport, 68%.

Using the latest National Child Measurement Programme (NCMP) data or the 3 years covering 2019/20 to 2021/22, the prevalence of childhood obesity is higher than average in this area, higher than average at age 4-5 and at age 10-11 in the WEHM area, and higher than average at age 10-11 in Bell Green. The prevalence of obesity in children at reception age (including severe obesity) is 9.7% in Bell Green, 16.2% in WEHM, and 10.8% across Coventry overall. This indicates that obesity rates are notably higher in WEHM compared to Bell Green and the city average at the reception age level. The data indicates that the area’s rate of obesity increases in line with that of the city between the ages of 5 and 11 i.e. children are becoming increasingly obese as they get older. For Year 6 children (aged 10-11), the prevalence of obesity (including severe obesity) is 30.4% in Bell Green, 30.6% in WEHM, and 24.8% % across Coventry overall. This data suggests that both Bell Green and WEHM have significantly higher rates of obesity among Year 6 children compared to the city average.

Source: National Child Measurement Programme (NCMP), NHS Digital 

What else is happening? What else can be done?

Priorities around improving access to parks and green spaces, reducing loneliness and social isolation, hyper local community interventions showcasing services to improve health and wellbeing support and promote communities’ health and lifestyles. Partnerships between the local sport centres, GoParks, and community organisations can help encourage people to access sports, leisure and exercise activities. While the neighbourhood does not have a great amount of green space, the partnership has helped enable and encourage people to step out of their neighbourhood borders; build community cohesion and promote physical activity.

To address health inequalities and establish an environment that promotes and preserves good health, it is important to acknowledge that lifestyle factors are rooted in socioeconomic conditions. Bell Green and WEHM have an abundance of groups working in the area to provide support to residents. It is important to continue to address access to affordable; lowering risky behaviours by changing social norms and connecting people to peer support groups, such as encouraging them to use health check services, sexual health check services, stop smoking services and improving their access to drop-in sessions for psychological therapy and child clinics in the neighbourhood.